Is heparin still necessary after primary angioplasty in the era of platelet glycoprotein IIb/IIIa receptor inhibitors? A review of the literature

Corrado Lettieri, Stefano De Servi, Francesca Buffoli, Marco Aroldi, Nicola Baccaglioni, Michele Romano, Luca Tomasi, Antonio Izzo, Roberto Zanini

Research output: Contribution to journalArticle

Abstract

While there is clear evidence for administering unfractionated heparin after systemic thrombolysis, there are not randomised trials supporting the usefulness of postprocedural heparin in the setting of primary angioplasty, especially in the era of glycoprotein IIb/IIIa inhibitors, and this issue is still a matter of debate. In this review we analysed the 30-day cardiac events of patients treated with primary angioplasty and abciximab, with or without postprocedural unfractionated heparin. We conducted a Medline search and eight studies were selected: in four of them heparin was continued for at least 12 h after the procedure (group 1), in the others heparin was used only during the procedure (group 2). The composite incidence of 30-day major adverse cardiac events was similar in the two groups (5.1 vs. 5.1%; 95% confidence interval 0.66-1.45; P = 0.91), whereas total bleeding occurred in 5.5% of group 1 compared with 3% of group 2 (relative risk 1.82; 95% confidence interval 1.19-2.80; P = 0.005). In conclusion, this review suggests that in the setting of primary angioplasty with concomitant glycoprotein IIb/IIIa inhibitors, postprocedural heparin does not appear to favourably affect cardiac and systemic ischaemic events and turns out to be associated with an increase in haemorrhagic complications.

Original languageEnglish
Pages (from-to)653-659
Number of pages7
JournalJournal of Cardiovascular Medicine
Volume7
Issue number9
DOIs
Publication statusPublished - Sep 2006

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Integrin beta3
Platelet Glycoprotein GPIIb-IIIa Complex
Angioplasty
Heparin
Confidence Intervals
Hemorrhage
Incidence

Keywords

  • Abciximab
  • Angioplasty
  • Heparin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Is heparin still necessary after primary angioplasty in the era of platelet glycoprotein IIb/IIIa receptor inhibitors? A review of the literature. / Lettieri, Corrado; De Servi, Stefano; Buffoli, Francesca; Aroldi, Marco; Baccaglioni, Nicola; Romano, Michele; Tomasi, Luca; Izzo, Antonio; Zanini, Roberto.

In: Journal of Cardiovascular Medicine, Vol. 7, No. 9, 09.2006, p. 653-659.

Research output: Contribution to journalArticle

Lettieri, Corrado ; De Servi, Stefano ; Buffoli, Francesca ; Aroldi, Marco ; Baccaglioni, Nicola ; Romano, Michele ; Tomasi, Luca ; Izzo, Antonio ; Zanini, Roberto. / Is heparin still necessary after primary angioplasty in the era of platelet glycoprotein IIb/IIIa receptor inhibitors? A review of the literature. In: Journal of Cardiovascular Medicine. 2006 ; Vol. 7, No. 9. pp. 653-659.
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